Why does my heel hurt most with the first steps?
The most common cause is irritation of the thick band under the foot, from heel to toes (plantar fasciitis). Overnight it shortens and tightens, so the first steps stretch it hard, and it hurts.
After a few minutes of walking the tissue warms up and the pain eases. It may return after you sit for a while, or after a long day on your feet.
Who gets it in Ipoh?
It shows up in people with very different lives:
- Hawkers, kitchen staff and shop assistants who stand all day on hard floors.
- Teachers who stand and walk between classrooms.
- Walkers and runners at Bukit Kledang, Gunung Lang or the Polo Ground who raise their distance fast.
- People who spend the day barefoot or in thin rubber slippers on tiled floors at home.
- People who have gained weight, or whose calves are tight.
Each of these adds load to the tissue under the heel. Read our pages on standing pain for hawkers and kitchen workers and slippers and heel pain.
What else can cause heel pain?
Not every sore heel is plantar fasciitis. Other causes include:
- The Achilles tendon at the back of the heel, which hurts higher up at the back.
- A bruised fat pad under the heel, from landing hard.
- A stress injury to the heel bone, usually after a sudden jump in running.
- Nerve irritation, with burning or tingling.
If your pain is at the back of the heel, see Achilles tendon pain. Pain after a fall, or night pain that does not ease, needs a doctor.
What can I do this week?
Start before you stand up.
- Before the first step, sit on the bed edge and pull your toes up toward your shin for thirty seconds, three times.
- Roll your foot over a frozen bottle or a firm ball for a few minutes.
- Put on supportive sandals or shoes at once, even indoors. Avoid walking barefoot on tiles.
- Stretch the calf against a wall twice a day.
- Cut back long standing or hard running for a week and rebuild slowly.
If you work standing, a cushioned mat in front of the stove or counter helps. Our page on plantar fasciitis footwear lists what to look for.
When should I see someone?
See a doctor or physiotherapist if the pain has lasted more than a few weeks. Go also if you cannot put weight on the heel, or see swelling, bruising or numbness. See a doctor sooner after a fall or if you have diabetes and a foot sore.
A physiotherapist checks your foot, calf and hip, builds a strength and stretch plan and advises on footwear. Our home physiotherapy lets us see the floors and footwear in your home.
Read about plantar fasciitis. Our Canning Garden centre is opening soon.